Active NPI
Lyn E. Flahardy, LCSW
- Clinical Social Worker
- Herrin, IL
National Provider Identifier
1508836362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904003812
- Practice address
- 109 Lou Ann Dr
Herrin, IL 62948-3733 - Phone
- (618) 988-1330
- Fax
- (618) 988-8321
- NPI assigned
- Jan 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904003812 | VA | Primary |
Addresses
Primary practice location
109 Lou Ann Dr
Herrin, IL 62948-3733
Mailing address
20791 Misty Waters PT
Pittsburg, IL 62974-1884
Phone (618) 982-2567
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904003812 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265932800000",
"number": "1508836362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20791 MISTY WATERS PT",
"city": "PITTSBURG",
"state": "IL",
"postal_code": "629741884",
"telephone_number": "618-982-2567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 LOU ANN DR",
"city": "HERRIN",
"state": "IL",
"postal_code": "629483733",
"telephone_number": "618-988-1330",
"fax_number": "618-988-8321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLAHARDY",
"first_name": "LYN",
"middle_name": "E.",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-25",
"last_updated": "2010-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904003812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herrin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.